Combination Of Angiotensin-converting Enzyme Inhibitor And Angiotensin-Ⅱ Receptor Blocker In Diabetic Kidney Disease

Diabetic Kidney Disease was one of the most serious and common diabetes complications,and also the leading cause of end-stage renal disease. Many researches indicated that the increased angiotensin Ⅱ was the main factor of kidney disease,the blocker of RAAS may delay the occurrence and progress of DKD.In the patients of DKD, ACEI or ARB monotherapy can reduce albuminuria, bring protection for kidney, which has been widely used in clinical.Combination ACEI and ARB can more effectively reduce blood press and albuminuria than monotherapy,delaying the development of DKD and bringing more significant protection for kidney.Meanwhile,combination treatment has no obvious effet on the incidence of hyperkalemia 、 hypotension or dry cough compared with monotherapy,the effet on GFR 、 Ccr 、 SCr 、 hospital admission rate and mortality rate has no statistical difference,the treatment has good security and tolerance.It has been proved that combination of RAAS blockers treatment has good efficacy and security。 However, a few studies have not confirmed the above benefits, therefore, further research is needed.